Mandatory Quarantine Facilities Activated in New York

Alarmed by the case of an Ebola-infected New York doctor, the governors of New Jersey and New York on Friday ordered a mandatory, 21-day quarantine for all medical workers and other arriving travelers who have had contact with victims of the deadly disease in West Africa.

The move came after a New York City physician who returned to the U.S. a week ago from treating Ebola patients in Guinea fell ill with the virus. Many New Yorkers were dismayed to learn that after he came home, Dr. Craig Spencer rode the subway, took a cab, went bowling, visited a coffee shop and ate at a restaurant in the city of 8 million.

New Jersey Gov. Chris Christie and New York Gov. Andrew Cuomo said the case led them to conclude that the two states need precautions more rigorous than those of the U.S. Centers for Disease Control and Prevention, which recommends monitoring of exposed people for 21 days but doesn’t require quarantine, in which they are kept away from others.

“It’s too serious a situation to leave it to the honor system of compliance,” Cuomo said.

Those who are forcibly quarantined will be confined either to their homes or, if they live in other states, to some other place, most likely a medical facility, the governors said. Those quarantined at home will receive house calls from health officials. Twenty-one days is the incubation period for the Ebola virus.

Dr. Howard Zucker, acting New York state health commissioner, said any medical personnel who have treated Ebola patients in the three Ebola-ravaged West African countries — Sierra Leone, Guinea and Liberia — will be automatically quarantined.

Cuomo said anyone arriving from the three countries will be questioned at the airport about their contact with Ebola patients.

The two governors gave no estimate of how many travelers would be subject to quarantine, but Cuomo said “we’re not talking about a tremendous volume of people coming in from these areas,” and added that there are no plans to hire more screeners at airports.

The two states are home to Kennedy Airport and Newark Liberty in New Jersey, both major international portals.

Spencer’s illness led lawmakers on Capitol Hill, scientists and ordinary New Yorkers to wonder why he was out on the town after his return from West Africa — and why stronger steps weren’t being taken to quarantine medical workers.

Health officials said that he followed U.S. and international guidelines in checking his temperature every day and watching for symptoms, and that he put no one at risk. But others said he should have been quarantined — either voluntarily or by the government — during the incubation period.

An automatic three-week quarantine makes sense for anyone “with a clear exposure” to Ebola, said Dr. Richard Wenzel, a Virginia Commonwealth University scientist who formerly led the International Society for Infectious Diseases.

Aid organizations such as Doctors Without Borders, the group Spencer was working for, have argued that mandatory quarantines are unnecessary because people with Ebola aren’t contagious until symptoms begin, and even then it requires close contact with body fluids.

Also, aid organizations have warned that many health care volunteers wouldn’t go to Ebola hot zones if they knew they would be confined to their homes for three weeks after they got back.

Spencer, a 33-year-old emergency room doctor, returned from Guinea on Oct. 17 and sought treatment Thursday after suffering diarrhea and a 100.3-degree fever. He was listed in stable condition at a special isolation unit at Bellevue Hospital Center, and a decontamination company was sent to his Harlem home. His fiancee, who was not showing symptoms, was being watched in a quarantine ward at Bellevue.

On the streets of New York, Michael Anderson was critical of the U.S. government and Spencer.

“He’s stupid, a complete idiot” for moving about in public, the longtime Manhattan resident said at Grand Central Station. “It’s his responsibility when you come back from Africa” not to put people at risk, he said.

Cuomo, too, was critical of Spencer, saying he did “great work” as a volunteer, but adding: “He’s a doctor and even he didn’t follow the voluntary quarantine. Let’s be honest.”

Nearly 4,900 people have died in the Ebola outbreak, most of them in Guinea, Liberia and Sierra Leone.

In other developments:

— One of the two Dallas nurses who caught Ebola from a patient was declared virus-free and released from a hospital in Bethesda, Maryland. Nina Pham, 26, said she felt “fortunate and blessed to be standing here today.” She later met with President Barack Obama at the White House. The other nurse, Amber Vinson, is in an Atlanta hospital, where she was said to “making good progress.”

— Millions of doses of two experimental Ebola vaccines could be ready for use in 2015, and five more experimental vaccines will start being tested in March, the World Health Organization said.

— In Mali, which reported its first case this week, authorities warned that many people are in danger because the toddler who brought the disease to the country was bleeding from her nose as she traveled on a bus from Guinea.

The World Health Organization is not recommending the quarantine of returning aid workers without symptoms, according to spokeswoman Sona Bari.

“Health care workers are generally self-monitoring and are aware of the need to report any symptoms, as this patient did,” she wrote in an email.

Bruce Johnson, president of SIM USA, a Christian organization based in North Carolina, said its staffers are told to follow the CDC guidelines. Beyond that, he said, they are told to avoid crowded public areas.

He warned that such measures could discourage volunteers.

Nurses, doctors and others who hold down regular jobs back home would say, “I want to go over and help for a month, but now you’re telling me that when I get back I can’t go to work for 21 days?” Johnson said. “Yes, I think that will dampen the generous spirit of people in the U.S. who want to go help.”

Johnson was echoed by Dr. Rick Sacra, a Massachusetts physician who was infected with Ebola while doing medical aid work in Liberia. He was evacuated to a specialized treatment center in Nebraska, recovered and was released last month.

“A three-week complete quarantine would eliminate two-thirds to three-quarters of the volunteers from the U.S.” going to West Africa, he said. “They wouldn’t be able to spare the time.”